ABSTRACT
Laparoscopic operations (LO) of adults are performed as a routine in many departments, while LO in children are only at their onset. During September 1994 to May 1995 at the Clinic of Paediatric Surgery and Traumatology in Brno the first 100 LO and two thoracoscopic operations were performed. The group is formed by children aged 3 to 17 years. Their mean age was 10.6 years. The number comprised 14 acute operations, the remainder were planned operations. There was no perioperative fatality. Complications included one abscess of the Douglas bag, once the necessity of minilaparotomy on account of minor haemorrhage after resection of Meckel's diverticulum by means of endoGIA and once because the size of the tumour. Early conversion was necessary in two patients.
Subject(s)
Laparoscopy , Adolescent , Age Factors , Child , Child, Preschool , Female , Humans , Laparoscopy/statistics & numerical data , MaleABSTRACT
The authors present a case dealing with the treatment of a congenital diaphragmatic hernia. The procedure comprises surgery, extracorporeal membrane oxygenation--ECMO, classical and non-conventional pulmonary ventilation and pharmacological treatment. By using these methods it is possible to treat successfully a certain group of neonates with a congenital diaphragmatic hernia.
Subject(s)
Extracorporeal Membrane Oxygenation , Hernia, Diaphragmatic/surgery , Hernias, Diaphragmatic, Congenital , Humans , Infant, Newborn , Male , Postoperative Care , Preoperative CareABSTRACT
The authors describe their initial experience, organization, and problems associated with the development of an EMCO centre. Its main activities are those of a neonatal ECMO centre (to a smaller extent paediatric ECMO and ECCO2R-LF PPV of adults) during the first 4 months of its existence. During the period the ECMO centre was contacted in 10 instances. The referring department indicated the ECMO centre correctly in six instances. However, at least in two instances too late and the patients died (during priming of the ECMO circuit or transport could not be implemented because of the critical condition). In two instances, however, the ECMO staff failed as it was unable to ensure a minimum of seven days of safe operation of ECMO and therefore ECMO was not provided. Based on this experience the authors present an organizational model of the ECMO unit which is formed ad hoc when needed and comprises specialists of various professions from the sphere of emergency medicine. The main purpose of the present paper is to inform referring departments on the indications, selection criteria, contraindications of ECMO in neonates and children and to ensure thus not only smooth communication between the ECMO centre and the referring department but in the first place early referral to the ECMO centre at a time when transport is not yet a problem.
Subject(s)
Extracorporeal Membrane Oxygenation , Adult , Child , Facility Design and Construction , Health Facility Administration , Humans , Infant , Infant, NewbornABSTRACT
The authors give an account of Rehbein's operation which they use with increasing frequency in the treatment of Hirschsprung's disease. This operation extended the range of operations and meets the basic requirements for treatment of Hirschsprung's disease. As compared with other operations of this disease, it is simpler from the technical aspect, has a favourable postoperative course and long-term results and can thus be recommended to departments of paediatric surgery.
